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Guides through decision to have surgery for aortic valve stenosis. Explains symptoms of aortic valve stenosis and when surgery is an option. Covers benefits and risks. Includes an interactive tool to help you make your decision.

Guides through decision to have surgery for aortic valve stenosis. Explains symptoms of aortic valve stenosis and when surgery is an option. Covers benefits and risks. Includes an interactive tool to help you make your decision.

Aortic Valve Stenosis: Should I Have Surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Aortic Valve Stenosis: Should I Have Surgery?

Your options

Key points to remember

Replacing the aortic valve can fix
the valve when you have
aortic valve stenosis. Surgery may help you live longer, feel better, and have a better quality of life.

Whether replacement is right for you is based on many things. These include your overall health, how severe your stenosis is, whether you have symptoms, how well blood is flowing through the valve, and how well your heart is pumping blood.

If you have severe stenosis but are otherwise healthy, surgery has a high rate of success and a low
risk of causing other problems. The risks of not replacing the valve are likely greater than the risks of surgery.

If you have severe stenosis, especially if you also have symptoms, your life may be much shorter if you don't have the valve replaced. People who have symptoms of aortic valve stenosis have a high risk of sudden death.

If you have mild or moderate stenosis, the risks of valve replacement surgery may outweigh the benefits. Your doctor may suggest that you wait until the stenosis gets worse.

Aortic valve
stenosis is a narrowing of the
aortic valve. The aortic valve allows blood to flow from the heart's lower left
chamber (ventricle) into the
aorta and to the body. Stenosis prevents the valve
from opening properly, forcing the heart to work harder to pump blood through
the valve. This causes pressure to build up in the left ventricle and thickens
the heart muscle.

Your heart can make up for aortic valve stenosis
and the extra pressure for a long time. But at some point, it won't be able to
keep up the extra effort of pumping blood through the narrowed valve. This can
lead to
heart failure.

Aortic valve stenosis gets worse slowly. For many years you may not feel
any symptoms. But at some point, the valve will become so narrow that symptoms
occur. Symptoms are often brought on
by exercise, when the heart has to work harder. Symptoms include:

Chest pain or pressure (angina). You
may have a heavy, tight feeling in your chest.

Feeling dizzy or
faint.

Feeling tired and being
short of breath.

A feeling that your heart is
pounding, racing, or beating unevenly (palpitations).

There are a few ways that doctors can treat aortic valve stenosis. But a surgery or procedure is the only treatment that will fix the valve.

Surgery. The most common surgery is valve replacement. This is typically an open-heart surgery. Surgery to repair the valve is not common.

Transcatheter valve replacement. A newer, less invasive way to replace an aortic valve is called transcatheter aortic valve replacement. This procedure is only available for a person who cannot have surgery or for a person who has a high risk of serious problems from surgery. It is a procedure that uses catheters in blood vessels to replace the aortic valve with a specially designed artificial valve. This procedure is available in a small number of hospitals. And it is not right for everyone.

Balloon valvuloplasty. A procedure called balloon valvuloplasty is another treatment option. But it does not fix the valve problem. And it is not right for everyone.
Balloon valvuloplasty is a less invasive procedure that makes the
valve opening bigger. It may be an option for some children, teens, or young adults
in their 20s. If a person who is too sick to have their aortic valve replaced right away, valvuloplasty may be used as a short-term fix until they can have the valve replaced.

Healthy lifestyle. Your doctor will probably recommend some lifestyle changes to keep your heart healthy. These include eating heart-healthy foods, being active, staying at a healthy weight, and not smoking.

Timing is important. If you have valve surgery too soon,
you face the risks of surgery before you need to. And you may also increase the
chance that you will need another new valve in the future. This chance depends on the type of valve you get. But if you
wait too long to have surgery, your heart may become damaged, leading to heart
failure.

Your doctor will check many things to see if your disease is bad enough to recommend surgery. These things include how severe your stenosis is, whether you have symptoms, how well blood is flowing through the valve, and how well your heart is pumping blood.

If you do not have severe stenosis yet, the risks of surgery may outweigh the benefits. Your doctor will likely recommend that you wait to have your valve replaced.

Valve replacement
surgery has a high rate of success and a low risk of causing other problems if
you are otherwise healthy.

In people who do not have left ventricular heart
failure, the risk of death from surgery ranges from 2% to 5%.1 That means that out of 100 people who have the surgery, 2 to
5 people will die and 95 to 98 people will live.

The risk is lower
for people who have the surgery when they are younger than 70. Out of 100 of
these people, 1 will die and 99 will live. The risk of death is higher in
people who have left ventricular heart failure and other signs that their heart
is not working well.1

Even if valve
replacement surgery is a success, you may have problems after surgery, such
as:

An increased risk of blood clots. These can break off and cause a
stroke or
heart attack. To reduce the risk of blood clots, you will take a blood-thinning medicine.

A need for another replacement valve.
This will depend on the type of valve you get and how long you live after you
have the surgery.

Incomplete relief from symptoms. Some types of valves do not have openings as wide as a normal
valve for a person your size. This can limit how well the valve works to
relieve your symptoms.

A valve that fails.
There is a small chance that the valve will not work. Your doctor will need to
check from time to time to make sure that your valve is working.

After you have the new valve, you'll need to take
antibiotics to prevent an infection of the valve anytime you have certain other
procedures, such as dental work or another surgery.

Heart
surgery, such as valve surgery, also can cause an irregular heartbeat (atrial fibrillation). This can cause clots to form and
increases your risk of stroke.

Most people who have severe aortic valve stenosis are older than 65.
But your age shouldn't stop you from having valve replacement surgery.

There are other health problems that may
increase the risks of surgery, though. These include
coronary artery disease,
heart failure, advanced cancer, and brain problems
because of a stroke. If you have other serious health problems, it's important
to think about whether surgery will improve your quality of life and your
chances of living a longer life.

Personal stories about aortic valve replacement surgery

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

A few days
ago, I began to notice how out of breath I am just walking up a few stairs in
my house. I've also been having some chest pain. I visited my doctor and found
that I have a severely narrowed aortic valve. Apparently I have had it for
years, but it's just now become bad enough that I'm having symptoms. My doctor
said I should have my valve replaced. I don't want to develop permanent heart
damage from this.

Maria
Theresa, age 67

My doctor heard a heart murmur during a
routine physical examination. I had an echocardiogram and found out that I have mild
aortic stenosis. I feel fine. I don't have any chest pain or shortness of
breath. My doctor said it could be many years before I have symptoms, if at
all. So we agreed that I would have an echo every 3 years to keep an eye on it.
And I will make sure to report any symptoms.

Maddie, age 40

I have
moderate aortic stenosis. It was discovered during some tests I had for
coronary artery disease. I'm scheduled to have coronary bypass surgery. My
cardiologist suggested that I have a new aortic valve put in at the same time I
have the bypass surgery. That way I only have to have one open-heart operation.

Ralph, age
58

I've known for years that I have aortic
stenosis. I'm now in the severe stage as far as the width of the valve opening.
I don't have any symptoms. But my doctor says my heart isn't pumping blood as well as it should be. My doctor said that replacing the valve could help me live longer, so I am going to have the surgery.

Fred, age 70

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery to replace your aortic valve

Reasons not to have surgery

I have symptoms of aortic valve stenosis.

I don't have symptoms.

More important

Equally important

More important

I don't have symptoms yet, but I have severe stenosis.

I don't have severe stenosis.

More important

Equally important

More important

Surgery is my chance to live a longer life.

I have other health problems, and I don't think this surgery will help me live longer.

More important

Equally important

More important

For me, the benefits of valve replacement outweigh the risks of the surgery.

I don't want to have surgery of any kind.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

NOT having surgery

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

If you have severe aortic valve stenosis, what is a treatment to fix your aortic valve?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Aortic Valve Stenosis: Should I Have Surgery?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Have surgery to replace your aortic valve.

Don't have surgery.

Key points to remember

Replacing the aortic valve can fix
the valve when you have
aortic valve stenosis. Surgery may help you live longer, feel better, and have a better quality of life.

Whether replacement is right for you is based on many things. These include your overall health, how severe your stenosis is, whether you have symptoms, how well blood is flowing through the valve, and how well your heart is pumping blood.

If you have severe stenosis but are otherwise healthy, surgery has a high rate of success and a low
risk of causing other problems. The risks of not replacing the valve are likely greater than the risks of surgery.

If you have severe stenosis, especially if you also have symptoms, your life may be much shorter if you don't have the valve replaced. People who have symptoms of aortic valve stenosis have a high risk of sudden death.

If you have mild or moderate stenosis, the risks of valve replacement surgery may outweigh the benefits. Your doctor may suggest that you wait until the stenosis gets worse.

FAQs

What is aortic valve stenosis?

Aortic valve
stenosis is a narrowing of the
aortic valve . The aortic valve allows blood to flow from the heart's lower left
chamber (ventricle) into the
aorta and to the body. Stenosis prevents the valve
from opening properly, forcing the heart to work harder to pump blood through
the valve. This causes pressure to build up in the left ventricle and thickens
the heart muscle.

Your heart can make up for aortic valve stenosis
and the extra pressure for a long time. But at some point, it won't be able to
keep up the extra effort of pumping blood through the narrowed valve. This can
lead to
heart failure.

What are the symptoms of aortic valve stenosis?

Aortic valve stenosis gets worse slowly. For many years you may not feel
any symptoms. But at some point, the valve will become so narrow that symptoms
occur. Symptoms are often brought on
by exercise, when the heart has to work harder. Symptoms include:

Chest pain or pressure (angina). You
may have a heavy, tight feeling in your chest.

Feeling dizzy or
faint.

Feeling tired and being
short of breath.

A feeling that your heart is
pounding, racing, or beating unevenly (palpitations).

What are the treatment options for aortic valve stenosis?

There are a few ways that doctors can treat aortic valve stenosis. But a surgery or procedure is the only treatment that will fix the valve.

Surgery. The most common surgery is valve replacement. This is typically an open-heart surgery. Surgery to repair the valve is not common.

Transcatheter valve replacement. A newer, less invasive way to replace an aortic valve is called transcatheter aortic valve replacement. This procedure is only available for a person who cannot have surgery or for a person who has a high risk of serious problems from surgery. It is a procedure that uses catheters in blood vessels to replace the aortic valve with a specially designed artificial valve. This procedure is available in a small number of hospitals. And it is not right for everyone.

Balloon valvuloplasty. A procedure called balloon valvuloplasty is another treatment option. But it does not fix the valve problem. And it is not right for everyone.
Balloon valvuloplasty is a less invasive procedure that makes the
valve opening bigger. It may be an option for some children, teens, or young adults
in their 20s. If a person who is too sick to have their aortic valve replaced right away, valvuloplasty may be used as a short-term fix until they can have the valve replaced.

Healthy lifestyle. Your doctor will probably recommend some lifestyle changes to keep your heart healthy. These include eating heart-healthy foods, being active, staying at a healthy weight, and not smoking.

Why is it important to wait for stenosis to get worse before having surgery?

Timing is important. If you have valve surgery too soon,
you face the risks of surgery before you need to. And you may also increase the
chance that you will need another new valve in the future. This chance depends on the type of valve you get. But if you
wait too long to have surgery, your heart may become damaged, leading to heart
failure.

Your doctor will check many things to see if your disease is bad enough to recommend surgery. These things include how severe your stenosis is, whether you have symptoms, how well blood is flowing through the valve, and how well your heart is pumping blood.

If you do not have severe stenosis yet, the risks of surgery may outweigh the benefits. Your doctor will likely recommend that you wait to have your valve replaced.

What are the benefits of surgery?

Replacing your valve can help you have a more normal life span, help you feel better, and improve your quality of life.

You will likely feel better after your valve is replaced, because blood will flow normally through the artificial valve.

If you have severe stenosis but don't have your valve replaced, you may die suddenly or develop heart failure. Replacing the valve can lower these risks.

What are the risks of surgery?

Valve replacement
surgery has a high rate of success and a low risk of causing other problems if
you are otherwise healthy.

In people who do not have left ventricular heart
failure, the risk of death from surgery ranges from 2% to 5%.1 That means that out of 100 people who have the surgery, 2 to
5 people will die and 95 to 98 people will live.

The risk is lower
for people who have the surgery when they are younger than 70. Out of 100 of
these people, 1 will die and 99 will live. The risk of death is higher in
people who have left ventricular heart failure and other signs that their heart
is not working well.1

Even if valve
replacement surgery is a success, you may have problems after surgery, such
as:

An increased risk of blood clots. These can break off and cause a
stroke or
heart attack. To reduce the risk of blood clots, you will take a blood-thinning medicine.

A need for another replacement valve.
This will depend on the type of valve you get and how long you live after you
have the surgery.

Incomplete relief from symptoms. Some types of valves do not have openings as wide as a normal
valve for a person your size. This can limit how well the valve works to
relieve your symptoms.

A valve that fails.
There is a small chance that the valve will not work. Your doctor will need to
check from time to time to make sure that your valve is working.

After you have the new valve, you'll need to take
antibiotics to prevent an infection of the valve anytime you have certain other
procedures, such as dental work or another surgery.

Heart
surgery, such as valve surgery, also can cause an irregular heartbeat (atrial fibrillation). This can cause clots to form and
increases your risk of stroke.

If you are older, should you still have surgery?

Most people who have severe aortic valve stenosis are older than 65.
But your age shouldn't stop you from having valve replacement surgery.

There are other health problems that may
increase the risks of surgery, though. These include
coronary artery disease,
heart failure, advanced cancer, and brain problems
because of a stroke. If you have other serious health problems, it's important
to think about whether surgery will improve your quality of life and your
chances of living a longer life.

Why might your doctor recommend valve replacement surgery?

Your doctor may advise you to have valve replacement
if:

You have severe stenosis.

You have symptoms of
stenosis.

There may be other reasons that your doctor recommends replacing the valve. Talk with your doctor about the benefits and risks for you.

2. Compare your options

Have surgery to replace
your aortic valve

Do not have surgery

What is usually involved?

The surgery can take 2 to 5 hours. You will stay in the hospital
4 to 5 days after surgery. You will have a big scar on your chest from the
incision.

It can take several weeks to recover.

You may take medicines to treat complications.

You can make lifestyle changes to help keep your heart healthy.

If you don't have severe stenosis, you will likely wait until the stenosis gets worse before you consider having surgery.

What are the benefits?

Valve replacement is a treatment that will fix the valve.

You
may feel better and live longer.

Valve replacement surgery has a high rate of success and a low
risk of causing other problems, if you are otherwise healthy.

You avoid the risks of surgery.

If you don't have
severe stenosis, you avoid having surgery too soon and maybe needing another valve
replacement later.

What are the risks and side effects?

All surgery has risks, including the risks of anesthesia and
bleeding.

The risk of dying from this surgery ranges from 1% to 5%.
This means that out of 100 people who have the surgery, 1 to 5 people will die
and 95 to 99 people will live.1

You may not be healthy enough to have surgery.

If the valve fails or wears out, you may need another surgery to replace the artificial valve.

If you wait too long to have surgery, your heart may become
damaged, leading to heart failure.

Medicines can treat complications,
but they won't fix the valve.

If you have severe stenosis and don't have
surgery, your life may be much shorter.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about aortic valve replacement surgery

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"A few days ago, I began to notice how out of breath I am just walking up a few stairs in my house. I've also been having some chest pain. I visited my doctor and found that I have a severely narrowed aortic valve. Apparently I have had it for years, but it's just now become bad enough that I'm having symptoms. My doctor said I should have my valve replaced. I don't want to develop permanent heart damage from this."

— Maria
Theresa, age 67

"My doctor heard a heart murmur during a routine physical examination. I had an echocardiogram and found out that I have mild aortic stenosis. I feel fine. I don't have any chest pain or shortness of breath. My doctor said it could be many years before I have symptoms, if at all. So we agreed that I would have an echo every 3 years to keep an eye on it. And I will make sure to report any symptoms."

— Maddie, age 40

"I have moderate aortic stenosis. It was discovered during some tests I had for coronary artery disease. I'm scheduled to have coronary bypass surgery. My cardiologist suggested that I have a new aortic valve put in at the same time I have the bypass surgery. That way I only have to have one open-heart operation."

— Ralph, age
58

"I've known for years that I have aortic stenosis. I'm now in the severe stage as far as the width of the valve opening. I don't have any symptoms. But my doctor says my heart isn't pumping blood as well as it should be. My doctor said that replacing the valve could help me live longer, so I am going to have the surgery."

— Fred, age 70

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery to replace your aortic valve

Reasons not to have surgery

I have symptoms of aortic valve stenosis.

I don't have symptoms.

More important

Equally important

More important

I don't have symptoms yet, but I have severe stenosis.

I don't have severe stenosis.

More important

Equally important

More important

Surgery is my chance to live a longer life.

I have other health problems, and I don't think this surgery will help me live longer.

More important

Equally important

More important

For me, the benefits of valve replacement outweigh the risks of the surgery.

I don't want to have surgery of any kind.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

NOT having surgery

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
If you have severe aortic valve stenosis, what is a treatment to fix your aortic valve?

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